About to start clinicals...stressed about knowledge base

[lemur87]

I am supposed to start clinicals in 2 weeks and am completely stressed out about what I DON't know. It is to the point where I am on the verge of dropping my classes and taking the summer off just to study.

I am worried that I don't know enough to go into clinicals. I will be in a family practice/community health setting and this is my adult health rotation. How much am expected to know in my first clinical rotation? Should I be so concerned? My background is NICU nursing so I am complete fish out of water.

Any advice is greatly appreciated!

[KyFNP13]

I just graduated from NP school in December so I remember those clinical days quite vividly. I would say that it is perfectly normal to experience some nervousness especially if you are going to not only be with a new population but also a new preceptor. I think that one thing I found as not only a registered nurse but also a nurse practitioner student that way deep down somewhere in our memories we know more than we are confident that we know.

One thing that I found helpful during clinicals was to focus on an organ system, and let your preceptor be aware what organ system is your focus each week. But let them know that you also want to know about any abnormalities that they notice that you may not. Being that you work NICU you may be very familiar with hearing heart murmurs, but that was my weakness. So I let my preceptor know and whenever she heard one I did not, she let me know even though my focus for health assessment may have been head and neck that week. You are learning and you are not expected to know everything be confident in what you do know and do not be afraid to not know something but always know where to find the answer.

Good luck and enjoy your time learning, it will go by so fast.

[Julia77]

In my Fitzgerald's FNP Review guide, she recommends reviewing the top 10 most common presentations seen at clinical site (eg., sore throat, headache) and researching each one in terms of patho, differential diagnosis, presentation, management.

I haven't started clinicals yet, but this seemed like good advice. I'm with you, though, there is SO MUCH TO KNOW!

Julia

[lmccrn62, MSN, RN]

We aren't expected to know everything. It's learning how to put it together. It comes with time. I would bring reference books to clinical so I could look things up.

[twinkerrs]

As my preceptor told me you won't even know everything when you graduate...that is why they call it practice. Best words of wisdom I ever had. Go in with a good attitude and a desire to learn and you will be ok. I like the idea of focusing on a system though that may not be possible in your setting each week. Also talk to your preceptor and find out how they want you to present the patient to them that helped me know how to view each patient for pertinent info.

[BostonFNP, APRN]

In the first clinical rotation I expect three things from my students when they walk through the door: the ability to elicit a complete history, the skills to do a complete physical exam, and to document those effectively.

Our goal for the first three weeks is making sure, first and foremost, that the student can distinguish normal for abnormal, and develop some basic differentials.

After that we work on how to appropriately focus exams and start to talk about plans.